Referral Policy

Except for visits to a hospital emergency room or an urgent care facility, a referral from an on-campus Medical Services or Counseling and Psychological Services provider is required for students in order to utilize the off-campus benefits available under the Columbia Student Health Insurance Plan. Providers at Medical Services and Counseling and Psychological services provide referrals after evaluation and treatment on campus has been completed and as the need for outside services is clinically indicated. You don’t need separate referrals each time you see the same provider for an ongoing condition.

Referrals for medical conditions will terminate on the last day of each plan year (August 31, 2014 for the 2013-14 plan year and August 14, 2015 for the 2014-15 plan year.)We recommend scheduling an appointment with your Primary Care Provider to determine if a referral for continued treatment is indicated. Referrals for mental health conditions for off-campus counseling and psychiatric services are valid as long as you remain continuously insured by the Columbia Plan.

If you are injured or become ill while traveling or spending an extended time away from Teachers College, you will need to call and speak with your Columbia Health provider to determine what kind of treatment is appropriate.

When you are not in New York City (during breaks, holidays) you will be covered for primary care, as well as other services, by the Aetna network of providers. If you are 50 miles or more away from the Morningside Columbia Medical Services a referral will not be required.

Even with a referral, you will be responsible for a copay and possible additional charges when seeing an off-campus consulting provider.

You may need a referral from your on-campus provider in advance.

A referral is NOT required under the following conditions, though your Columbia Health provider can assist you in finding appropriate services:

For women 35-40: one baseline mammogram; one per year thereafter for women age 40 and older. Coverage will be provided more frequently if recommended by a clinician for a covered person who has a prior history of breast cancer or who has a first-degree relative with a prior history of breast cancer.

One annual routine Pap smear screening and office visit; Pap smear screenings and women’s health care visits are available on campus where a student pays no copay or deductible, and all associated laboratory tests are covered. If additional appropriate testing is performed as part of an off-campus annual office visit, benefits for the testing will be payable in accordance with the Plan's policy and the student may be responsible for a portion of the laboratory testing. No referral will be needed.

Referrals for Spouse/Domestic Partners

Effective September 1, 2014 a referral from an on-campus Medical Services provider is required for spouse/domestic partners enrolled in the Columbia Plan in order to utilize the off-campus medical benefits available under the Columbia Student Health Insurance Plan. Referrals for off-campus mental health services are not required.